| NPI | 1710768601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11033398) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9407764) |
| Enumeration Date | 2023-10-09 |
| Last Update Date | 2025-01-17 |